Marconi J
Acta Psiquiatr Psicol Am Lat. 1979 Sep;25(3):204-11.
The mental disorder is a biopsychosocial phenomenon. Starting from this idea, this paper suggests the active participation of every psychiatric professional with the organizated help of community groups, specially trained in mental health matters. A double social function is obtained by this: 1) programmed public training, and 2) practical performance in the assistence field of the same community. In Chile, in general, two social stratus are distinguished; the european culture (middle and upper class) and the popular aboriginal culture (working and rural class). Both have their own pattern about medicine: the european culture, based on the scientific concept, and the popular one based on the magic-religious thoughts. Between them, there exists a barrier. On the one hand, there is not sufficient scientific medical assistence on a national level; on the other hand, the popular medicine is precarious, but more effective in its social function (low cost, availability, absence of bureaucracy, human contact, comprehensible language of medicasters, etc.). The Integral Mental Health Programme objective, in this point, is to join a minimum of the popular medicine sociological structure with the actions of the scientific medicine. Interaction between these will be produced according to the transculturation principles. Patterns for training the 5 levels of the functions delegation are given.
精神障碍是一种生物心理社会现象。基于这一观点，本文建议在社区团体（在心理健康问题方面接受过专门培训）的有组织帮助下，每位精神科专业人员积极参与其中。这样做可获得双重社会功能：1）有计划的公众培训，以及2）在同一社区的援助领域开展实际工作。在智利，总体上可区分出两个社会阶层；欧洲文化（中上层阶级）和本土大众文化（工人和农村阶级）。两者都有各自的医学模式：欧洲文化基于科学概念，而大众文化基于魔法宗教思想。它们之间存在障碍。一方面，在国家层面上科学医疗援助不足；另一方面，大众医学不稳定，但在其社会功能方面更有效（低成本、可及性、无官僚作风、人际接触、行医者易懂的语言等）。在这一点上，综合心理健康计划的目标是将大众医学社会学结构的最少部分与科学医学的行动结合起来。它们之间的互动将根据文化适应原则产生。文中给出了五级职能委托的培训模式。
